S20 Impact of Sarcopenia on Complications in Patients Admitted With Acute Pancreatitis: A Nationwide Analysis

Introduction: Sarcopenia, the progressive loss of muscle mass, is a known prognostic factor in various illnesses. Acute pancreatitis (AP), an inflammatory pancreatic disorder, involves significant metabolic stress. While malnutrition is linked to increased mortality and costs in AP, the specific impact of sarcopenia on clinical outcomes in hospitalized AP patients remains underexplored. Methods: We used the National Inpatient Sample 2016 to 2022 to identify adult patients (>18 years). Patients with AP were stratified into 2 groups based on the presence of sarcopenia. Patients with missing demographics or mortality data were excluded. Multivariate logistic regression model was used to assess the association of sarcopenia with various clinical outcomes, adjusting for patient demographics, comorbidities, etiology of pancreatitis, and hospital-acquired infections. Results: Out of 2,467,233 patients were admitted with AP, 227,545 (9.2%) diagnosed with sarcopenia. The majority of sarcopenic patients were aged 45-65 years (40.3%), men (53.6%), White (65.2%), and had Medicare insurance (42%). Patients with sarcopenia had a higher incidence of in-hospital mortality (7.3% vs 2%), sepsis (7.3% vs 4.6%), shock (14.6% vs 3.6%), acute kidney injury (37.9% vs 18%), deep vein thrombosis (3.7% vs 0.7%), pulmonary embolism (1.7% vs 0.5%), portal vein thrombus (2.8% vs 0.8%) and ileus (7.6% vs 3.2%). Patients with sarcopenia had a higher prevalence of infections such as urinary tract infection (13.4% vs 7.6%), pneumonia (11.7% vs 4%), cholangitis (3.1% vs 2.2%), C. difficile (3.6% vs 1%), and cellulitis (2% vs 0.8%). After adjusting for confounding factors, patients with sarcopenia had higher odds of in-hospital mortality (adjusted odds ratio [aOR]-1.41, 95% CI-1.34-1.48, P < 0.001), shock (aOR-1.92, 95% CI-1.85-2.00, P < 0.001), acute kidney injury (aOR-1.41, 95% CI-1.41-1.49, P < 0.001), intensive care unit admission (aOR-1.79, 95% CI-1.72-1.87, P < 0.001), pulmonary embolism (aOR-1.60, 95% CI-1.41-1.82, P < 0.001), deep vein thrombosis (aOR-2.37, 95% CI-2.21-2.54, P < 0.001), portal vein thrombus (aOR-2.57, 95% CI-2.38-2.77, P < 0.001) and ileus (aOR-1.70, 95% CI-1.63-1.77, P < 0.001). Conclusion: Our study notes that AP patients with sarcopenia are at higher risk of worse outcomes compared to those without sarcopenia. Early identification and targeted interventions—such as nutritional support and close monitoring—may help mitigate risks and improve outcomes in this high-risk population.